Dermatology specialist care wait times are at an all time high: latest figures show over 336,000 patients waiting for clinic appointments in England, over 13,000 of whom have been waiting for over a year.
The longer wait times become, the more risk and stress patients are exposed to. No doctor wants to see their patients stuck in an endless queue, but managing such intense demand as the healthcare workforce crisis bites is proving a serious challenge for the NHS.
These conditions are fueling an appetite for tech solutions across primary and secondary care, as clinicians embrace digital tools to diagnose, refer and collaborate on skincare delivery. Cinapsis are proud to be working together with HEINE, the inventors of the dermatoscope, to facilitate teledermatology in several regions across England.
HEINE Optotechnik is a family-owned company based in Germany, where they manufacture world-leading primary diagnostic instruments. In 1989, HEINE invented the first dermatoscope, a portable visual aid device that enables doctors to examine skin lesions unobstructed by skin surface reflections.
Cinapsis & HEINE: the partnership
HEINE dermatoscopes can be fitted to smartphone cameras, so GPs can capture high-quality images of their patients’ skin lesions. However, if the GP also has the Cinapsis app downloaded on their smartphone, these images can be directly uploaded, attached to a digital advice and guidance request, and sent to a secondary care specialist. This visual aid makes it much easier and faster for the dermatology specialist to diagnose the lesion and advise on the best course of treatment for the patient - whether that be the Two Week Wait pathway, clinic referral, or course of medication.
The images, and the outcomes of the referral or advice and guidance, are automatically updated in the patient record via an NHS ERS and EMIS integration. To ensure safety and compliance, no clinical images are stored on the smartphone photo gallery, only on the Cinapsis platform itself.
Impact in practice
In Cheshire & Merseyside, GPs have been using HEINE and Cinapsis together to great effect. Prior to the technology partnership roll-out:
- 30% of dermatology Two Week Wait (2WW) referrals were classed as ‘unnecessary’
- This was amounting to approximately 7,000 unnecessary referrals every year, at a cost of over £1 million to the ICS
However, in the 6 months following the expansion of the teledermatology pilot in the region, all patients are now being correctly referred to the most appropriate source of care. 45% of dermatology cases are now managed with Advice & Guidance alone, patients who do have clinically worrying lesions are being redirected into the appropriate clinic earlier on, and those with benign lesions are screened out and need not make the journey to hospital.
Clinician resources are being freed up to tackle wait times for other dermatological conditions.
Dr Stephanie Gallard, GP & Primary Care Lead for Elective Dermatology within Cheshire and Merseyside Health & Care Partnership, said:
“Historically, my GP colleagues and I had to waste hours wrestling with clunky, poorly-integrated photo-sharing technologies if we were able to attach photos at all in a data compliant manner. Aside from the heavy burden it was placing on our time, this was leading too many dermatology referrals to be made without high-quality images. This meant that patients were often called in for a face-to-face specialist appointment when they did not need special treatment, or when they could have been more appropriately managed in primary care.
“Now that I can use a HEINE dermatoscope to capture clinical images, and the Cinapsis platform to manage patient referrals and access specialist second-opinions within days, I’ve been able to work more efficiently and treat patients more effectively. The entire referral process is now faster and more accurate: this means that my patients receive the right care, first time around. The reduction in manual administration and time-intensive data entry also frees up more time for me to spend with patients. Because all the information and actions are automatically synced to the ERS, it’s easy for me to monitor the patient’s condition and make sure that nothing slips through the net.”
Dr Richard Azurdia, Consultant Dermatologist at Liverpool University Hospitals NHS Foundation Trust, said:
“As a Consultant Dermatologist, receiving high-quality HEINE images attached to every patient advice and guidance skin lesion referral via Cinapsis is incredibly helpful. I can quickly review all the necessary information and make an informed, collaborative decision with the referring GP using an effective electronic solution.”
Sean Lyons, UK & Ireland Country Manager at HEINE Optotechnik, said:
“HEINE are delighted to support the development of teledermatology in the UK with the very highest quality dermatoscopes built entirely in Germany. Our partnership with Cinapsis means that we can offer a comprehensive solution which helps the GP capture crystal clear images and in turn ensure that the referral process is faster and more accurate.”